Vaccine hesitancy and anti-vaccination attitudes during the start of COVID-19 vaccination program: A content analysis on Twitter data

Background Vaccine hesitation, which is defined as one of the most important global health threats by World Health Organization, maintains its universal importance during the COVID-19 period. Due to the increasing appearance of anti-vaccine arguments on social media, Twitter is a useful resource in detecting these contents. In this study, we aimed to identify the prominent themes about vaccine hesitancy and refusal on social media during the COVID-19 pandemic. Methods In this qualitative study we collected Twitter contents which contain a vaccine-related keywords and published publicly between 9/12/2020 and 8/1/2021 (n=551,245). A stratified random sample (n=1041) is selected and analyzed by four researchers with content analysis method. Results All tweets included in the study were shared from 1,000 unique accounts of which 2.7% were verified and 11.3% organizational users. 90.5% of the tweets were about vaccines, 22.6% (n=213) of the tweets mentioned at least one COVID-19 vaccine name and the most frequently mentioned COVID-19 vaccine was CorronaVac (51.2%). Yet, it was mostly as “Chinese vaccine” (42.3%). 22.0% (n=207) of the tweets included at least one anti-vaccination theme. Among tweets that included an anti-vaccination theme; poor scientific processes (21.7%), conspiracy theories (16.4%), and suspicions towards manufacturers (15.5%) were the most frequently mentioned themes. The most co-occurred themes were “Poor scientific process” theme come along with “suspicion towards manufacturers” (n=9) and “suspicion towards health authorities” (n=5). Conclusions This study may be helpful for health managers to identify the major concerns of the population and organize the preventive measures, through the significant role of social media on early information about vaccine hesitancy and anti-vaccination attitudes.